Prevalence and Risk Factors of H. pylori from Dyspeptic Patients in Northwest Ethiopia: A Hospital Based Cross-sectional Study

  • Abebaw, Wubejig (Department of Biology, Science College, Bahir Dar University) ;
  • Kibret, Mulugeta (Department of Biology, Science College, Bahir Dar University) ;
  • Abera, Bayeh (Department of Microbiology, Immunology and Parasitology, College of Medicine and Health Sciences, Bahir Dar University)
  • Published : 2014.06.15


Background: Gastric cancer is the second leading cause of cancer-related deaths worldwide and infection with H. pylori is considered essential for its development. Helicobacter pylori infects more than 50% of the world's population with higher prevalence in developing countries than developed countries. The prevalence of H. pylori varies in different societies and geographical locations. The objectives of this study were to estimate the seroprevalence and determine the risk factors of H. pylori infection in dyspeptic patents in Ethiopia. Materials and Methods: A cross-sectional study involving 209 dyspeptic patients was carried out from February 15 to April 30, 2013. Five to ten ml venous blood was collected from each dyspeptic patient and analyzed for detection of Helicobacter pylori immunoglobulin (IgG). The socio-demographic characteristic, hygienic practices, alcohol consumption, sources of drinking water and types of latrine were also obtained with a pre-tested questionnaire. Results: The overall seroprevalence of Helicobacter pylori was 72.2%. There was statistically significant difference in the prevalence of H. pylori among age groups (p=0.02). Seroprevalence of H. pylori was higher in those patients who used unprotected surface water (76.4%) than those with access to piped tap water (65.9%). There was also statistically significant differences in prevalence of H. pylori with the habit of hand washing before meal (p=0.01) and alcohol consumption (p=0.001). Conclusions: The prevalence of H. pylori was high in the study area and increased with age of dyspeptic patients. Alcohol consumption and the type of drinking water are risk factors that have associations with the prevalence of H. pylori. Molecular epidemiological techniques can show a true picture of H. pylori and improvement in the drinking water quality is recommended.


  1. Ahmed KS, Khan AA, Ahmed I, et al (2007). Impact of household hygiene and water source on the prevalence and transmission of H. pylori: a South Indian perspective. Singapore Med J, 48, 543-9.
  2. Agha A, Graham DY (2005). Evidence-based examination of the African enigma in relation to Helicobacter pylori infection. Scand J Gastroenterol, 40, 523-9.
  3. Aguemon BD, Struelens MJ, Massougbodji A, et al (2005). Prevalence and risk-factors for Helicobacter pylori infection in urban and rural Beninese populations. Clin Microbiol Infect, 11, 611-7.
  4. Alizadeh AHM, Ansari S, Ranjba M, et al (2009). Seroprevalence of Helicobacter pylori in Nahavand: a population based study. Eastern Mediterranean Health J, 15, 129-5.
  5. Alvarado-Esquivel C (2013). Seroepidemiology of Helicobacter pylori infection in a Mennonite Community in Durango State, Mexico. Helicobacter, 18, 215-21.
  6. Ameri GA, Alkadasi MN (2013). The prevalence of Helicobacter pylori and risk factors of infection associated in Taiz city, Yemen. Int J Curr Microbiol Appl Sci, 2, 226-3.
  7. Asrat D, Nilsson I, Mengistu Y, et al (2004). Prevalence of Helicobacter pylori infection among adult dyspeptic patients in Ethiopia. Trop Med Parasitol, 98, 181-9.
  8. Banatvala N, Mayo K, Megraud F, et al (1993). The cohort effect and Helicobacter pylori. J Infect Dis, 168, 219-1.
  9. Basiri Z, Safaralizadeh Z, Bonyadi MJ, et al (2014). Helicobacter pylori vacA d1 genotype predicts risk of gastric adenocarcinoma and peptic ulcers in Northwestern Iran. Asian Pac J Cancer Prev, 15, 1575-9.
  10. Campbell DI, Warren BF, Thomas JE, et al (2001). The African enigma: low prevalence of gastric atrophy, high prevalence of chronic inflammation in West African adults and children. Helicobacter, 6, 263-7.
  11. Brenner H, Berg G, Lappus N (1990). Alcohol consumption and Helicobacter pylori infection: results from the German National Health and Nutrition Survey. Epidemiology, 10, 214-8.
  12. Brown M, Thomas LT, Ma J, et al (2002). Helicobacter pylori infection in rural China: demographic, lifestyle and environmental factors. Int J Epidemiol, 31, 638-6.
  13. Bures J, Kopacova M, Skodov-Fendrichova M, et al (2011). Epidemiology of Helicobacter pylori infection. Vnitr Leki 57, 993-9.
  14. Demirel BB, Akkas BE, Vural GU (2013). Clinical factors related with Helicobacter pylori infection: is there an association with gastric cancer history in first-degree family members? Asian Pac J Cancer Prev, 14, 1797-2.
  15. Desta K, Asrat D, Derebie F (2002). Seroprevalence of Helicobacter pylori infection among health blood donors in Addis Ababa Ethiopia. Ethiop J Health Sci, 12, 109-6.
  16. Dorji D, Dendup T, Malaty HM, et al (2013). Epidemiology of Helicobacter pylori in Bhutan: the role of environment and geographic location. Helicobacter, 19, 69-73.
  17. Dube C, Tanih NF, Clarke AM, et al (2009). Helicobacter pylori infection and transmission in Africa: household hygiene and water sources are plausible factors exacerbating spread. Afr J Biotech, 8, 6028-5.
  18. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  19. GLOBOCAN (2014). Estimated cancer incidence, mortality and prevalence Worldwide in 2012. accessed on 14 March 2014.
  20. Hunt RH, Xiao SD, Megraud F, et al (2011). Helicobacter pylori in developing countries. J Gastroenterointest Liver Dis, 20, 299-4.
  21. Herbarth O, Krumbiegel P, Fritz GJ, et al (2010). Helicobacter pylori prevalence and risk factors among school beginners in a German urban centre and its rural county. Environ Health Perspect, 109, 573-7.
  22. IARC (1994). IARC monograph on the evaluation of carcinogenic risks to humans: schistosomes, liver flukes and Helicobacter pylori. IARC, 61, 177-240.
  23. Goodman KJ, Correa P, Tengana Aux HJ, et al (1996). Helicobacter pylori infection in the Colombian Andes: a population-based study of transmission pathways. Am J Epidemiol, 144, 290-9.
  24. Karami N, Talebkhan Y, Saberi S, et al (2013). Seroreactivity to Helicobacter pylori antigens as a risk indicator of gastric cancer. Asian Pac J Cancer Prev, 14, 1813-7.
  25. Lindkvist P, Enquselassie F, Asrat D, et al (1998). Risk factors for infection with Helicobacter pylori a study of children in rural Ethiopia. Scand J Infect Dis, 30, 371-6.
  26. Mansour-Ghanaei F, Mashhour YM, Joukar F, et al (2009). Prevalence of Helicobacter pylori infection among children in Rasht, Northern Iran. Middle East J Dig Dis, 1, 84-8.
  27. Mathewos B, Moges B, Dagnew M (2013.) Seroprevalence and trend of Helicobacter pylori infection in Gondar University Hospital among dyspeptic patients North West Ethiopia. BMC Res Notes, 6, 346.
  28. Moges F, Kassu A, Mengestu G, et al (2006). Seroprevalence in dyspeptic patients and its relationship with HIV infection, ABO blood group and life style in a university hospital, North west Ethiopia. World J Gastroenterol, 12, 1957-1.
  29. Ruggiero P (2010). Helicobacter pylori and inflammation. Curr Pharm Des, 16, 4225-6.
  30. Ndip NR, Malange EA, Akoachere TFJ, et al (2004). Helicobacter pylori antigens in the feces of asymptomatic children in the Buea and Limbe health districts of Cameroon: a pilot study. Trop Med Int Health, 9, 1036-40.
  31. Ogihara A, Kikuchi S, Hasegawa A, et al (2000). Relationship between Helicobacter pylori infection and smoking and drinking habits. J Gastroenterol Hepato, 15, 271-6.
  32. Paunio M, Hook-Nikanne J, Kosunen TU, et al (1994). Association of alcohol consumption and Helicobacter pylori infection in young adulthood and early middle age among patients with gastric complaints: a case-control study on Finnish conscripts, officers and other military personnel. Eur J Epidemiol, 10, 205-9.
  33. Sachs G, Scott DR, Wen Y (2011). Gastric infection by Helicobacter pylori. Curr Gastroenterol Rep, 13, 540-6.
  34. Salih BA (2009). Helicobacter pylori Infection in Developing Countries: the burden for how long? Saudi J Gastroentero, 15, 201-7.
  35. Sasidharan S, Lachumy ST, Ravichandran M, et al (2010). Epidemiology of Helicobacter pylori among multiracial community in Northern Peninsular, Malaysia: effect of age across race and gender. Asian J Trop Med, 45, 72-5.
  36. Sheikhian A, Ataherian S, Defan M, et al (2011). Prevalence and risk factors of Helicobacter pylori infection among health center referrals in Khorramabad (Western Iran). Asian J Epidemiol, 4, 1-8.
  37. Shmuely H, Samson O, Douglas J, et al (2003). Dyspepsia symptoms and Helicobacter pylori infection, Nakuru, Kenya. South Afr Med J, 9,1103-7.
  38. Torres J, Leal-Herrera Y, Perez-Perez G, et al (1998). A community-based seroepidemiologic study of Helicobacter pylori infection in Mexico. J Infect Dis, 178, 1089-4.
  39. Tadege T, MengistuY, Desta K, et al (2005). Seroprevalence of Helicobacter pylori infection in and its relationship with ABO blood groups. Ethiop J Health Dev, 19, 55-9.
  40. Tanih NF, Ndip LM, Clarke AM, et al (2010). An overview of pathogenesis and epidemiology of Helicobacter pylori infection. Afr J Microbiol Res, 4, 426-6.
  41. Tanih NF, Okeley BI, Ndip LM, et al (2011). Helicobacter pylori prevalence in dyspeptic patients in the Eastern Cape provincerace and disease status. South Afri Med J, 100, 734-7.
  42. Valliani A, Khan F, Chagani B, et al (2013). Factors associated with Helicobacter pylori infection: results from a developing country-Pakistan. Asian Pac J Cancer Prev, 14, 53-6.
  43. Zhang B, Hao GY, Gao F, et al (2013). Lack of association of common polymorphisms in MUC1 gene with Helicobacter pylori infection and non-cardia gastric cancer risk in a Chinese population. Asian Pac J Cancer Prev, 14, 7355-8.
  44. Zhong C, Li NK, Bi JW, et al (2012). Sodium intake, salt taste and gastric cancer risk according to Helicobacter pylori infection, smoking, histological type and tumor site in China. Asian Pac J Cancer Prev, 13, 2481-4.

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